Immediate parent-infant skin-to-skin study (IPISTOSS): study protocol of a randomised controlled trial on very preterm infants cared for in skin-to-skin contact immediately after birth and potential physiological, epigenetic, psychological and neurodevelopmental consequences.

Journal: BMJ open

Volume: 10

Issue: 7

Year of Publication: 2021

Affiliated Institutions:  Women's and Children's Health, Karolinska Institute, Stockholm, Sweden agnes.linner@ki.se. Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. Department of Paediatrics, Stavanger Universitetssjukehus, Stavanger, Norway. Neonatal Unit, Karolinska University Hospital, Stockholm, Sweden. Global Risk Governance Programme, Law Faculty, University of Cape Town, Rondebosch, Western Cape, South Africa.

Abstract summary 

In Scandinavia, 6% of infants are born preterm, before 37 gestational weeks. Instead of continuing in the in-utero environment, maturation needs to occur in a neonatal unit with support of vital functions, separated from the mother's warmth, nutrition and other benefits. Preterm infants face health and neurodevelopment challenges that may also affect the family and society at large. There is evidence of benefit from immediate and continued skin-to-skin contact (SSC) for term and moderately preterm infants and their parents but there is a knowledge gap on its effect on unstable very preterm infants when initiated immediately after birth.In this ongoing randomised controlled trial from Stavanger, Norway and Stockholm, Sweden, we are studying 150 infants born at 28+0 to 32+6 gestational weeks, randomised to receive care immediately after birth in SSC with a parent or conventionally in an incubator. The primary outcome is cardiorespiratory stability according to the stability of the cardiorespiratory system in the preterm score. Secondary outcomes are autonomic stability, thermal control, infection control, SSC time, breastfeeding and growth, epigenetic profile, microbiome profile, infant behaviour, stress resilience, sleep integrity, cortical maturation, neurodevelopment, mother-infant attachment and attunement, and parent experience and mental health.The study has ethical approval from the Swedish Ethical Review Authority (2017/1135-31/3, 2019-03361) and the Norwegian Regional Ethical Committee (2015/889). The study is conducted according to good clinical practice and the Helsinki declaration. The results of the study will increase the knowledge about the mechanisms behind the effects of SSC for very preterm infants by dissemination to the scientific community through articles and at conferences, and to the society through parenting classes and magazines.Recruiting since April 2018. Expected trial termination June 2021.NCT03521310 (ClinicalTrials.gov).

Authors & Co-authors:  Linnér Agnes A Westrup Björn B Lode-Kolz Karoline K Klemming Stina S Lillieskold Siri S Markhus Pike Hanne H Morgan Barak B Bergman Nils Johannes NJ Rettedal Siren S Jonas Wibke W

Study Outcome 

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Statistics
Citations :  WHO Report “Born Too Soon: the global action report on preterm birth. Available: https://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf
Authors :  10
Identifiers
Doi : e038938
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Epigenesis, Genetic
Other Terms
developmental neurology & neurodisability;maternal medicine;neonatal intensive & critical care;neonatology
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England